BARIUM SWALLOW

(CINE OESOPHAGRAM)
BY
HYELHIRRA P. MSHELIA
RADIOLOGY DEPARTMENT
BIU GENERAL HOSPITAL
BORNO STATE

march 2019
 TABLE OF CONTENTS
 INTRODUCTION
 BRIEF ANATOMY OF THE
OESOPHAGUS
 INDICATIONS
 TECHNIQUES
AFTERCARE
COMPLICATION
 INTRODUCTION
 Barium swallow is a radiological
investigation which involve the use of contrast
media to outline the upper GIT.
Barium opacifies and best demonstrate the
anatomy of the esophagus.
 BRIEF ANATOMY
It is a muscular, tubular structure about 25cm long.

It has cervical, thoracic and short

intraabdominal portion
Begins from cricoid cartilage (c5/c6) as continuation of
oropharynx to gastroesophageal junction (T10).
It pierces the diaphragm approx. 2.5cm to the left of the
midline to enter the abdomen.
Majority of its course is within the
 INDICATION
 Dysphagia
 Unexplained anaemia
 Pain on swallowing
 Assessment of oesophageal fistulae
 Assessment of the site of
perforation(traumatic or neoplastic
 CONTRA INDICATION
ABSOLUTE
None. (chapman and Nakienly 2001)
RELATIVE
Obstruction
perforation

Radiopedia 2019.
 CONTRAST MEDIA
 Barium sulphate 100ml (or as required)
 LOCM (approx. 350 mg I/ml).
 Gastrografin
 EQUIPMENT
 fluoroscopy unit
 spot film device
 conventional x-ray unit
 kidney dish, tray and stairers
 Contrast
 PATIENT PREPARATION
• Patient should not eat from midnight of the
day of examination
 PRELIMINARY FILM
• preliminary orcontrol film should be
obtained to check for obstruction or
perforation
 TECHNIQUE
 The patient is in the erect RAO position to throw the
oesophagus clear of the spine.
 An ample mouthful of barium is swallowed.
 spot films of the upper and lower GIT is taken
 Oesophageal varices are better seen in the prone RPO
position, as they will be more distended.
 If rapid serial radiography is required, it may be
performed in the right lateral, RAO and PA positions.
 lMAGE APPEARANCE
 The oesophagus appears as a long
tubular radiolucent structure on a
radiograph
 Double contrast when employed gives mucosal
details.
 On PA the cervical esophagus is seen to curve
slightly to the left.
 On a lateral view, the esophagus is seen anterior to
the cervical spine.
• .
.
Imaging demonstrating the mucosal lining
Aspiration
 AFTERCARE
• patient should be informed that he would
experience a whitish stool for a day or two
• Constipation may occur so
 COMPLICATIONS
 Leakage of barium from an unsuspected
perforation
 Aspiration.
 CONCLUSION
 Barium swallow with fluoroscopy provide a useful
alternative to evaluate esophageal motility.
 REFERENCES

Chapman and Nakielny (2009); A guide to radiological

procedure. 5th ed. Saunders Elsevier 2009
Indebir Singh (2002); Essentials of anatomy. 1st ed.
Jaypee, 2002
Radiopedia websearch 2019.
A.Adams;Diagnostic imaging and therapeutics,Barts and the
London NHS trust,London,UNITED KINDOM.
Clinical orientated anatomy/Keith L.Moore,Arthur F.Dalley,Anne
M.R.Agur 7th Ed.(2006).Drake:
Gray's Anatomy for students 2nd Ed.(2009) by Churchill living
stone,an imprint of Elsevier Inc.All right reserved.
THANK
YOU